Paclitaxel-Associated Hypersensitivity Reactions: Experience of the Gynecologic Oncology Program of the Cleveland Clinic Cancer Center

• Published in: Journal of clinical oncology Vol. 18; no. 1; pp. 102 - 105
• Main Authors: MARKMAN, M, KENNEDY, A, WEBSTER, K, KULP, B, PETERSON, G, BELINSON, J
• Format: Journal Article
• Language: English
• Published: Baltimore, MD American Society of Clinical Oncology 01.01.2000; Lippincott Williams & Wilkins
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Clinical Protocols; Desensitization, Immunologic - methods; Dexamethasone - therapeutic use; Diphenhydramine - therapeutic use; Drug Hypersensitivity - etiology; Drug Hypersensitivity - prevention & control; Drug Therapy, Combination; Drug toxicity and drugs side effects treatment; Famotidine - therapeutic use; Female; Genital Neoplasms, Female - drug therapy; Glucocorticoids - therapeutic use; Histamine H1 Antagonists; Histamine H2 Antagonists - therapeutic use; Humans; Medical sciences; Middle Aged; Miscellaneous (drug allergy, mutagens, teratogens...); Paclitaxel - administration & dosage; Paclitaxel - adverse effects; Pharmacology. Drug treatments; Premedication; Antineoplastic agent; Human; Toxicity; Hypersensitivity; Malignant tumor; Female genital diseases; Prevention; Chemotherapy; Treatment; Taxane derivatives; Female genital system; Paclitaxel; Female
• ISSN: 0732-183X; 1527-7755
• DOI: 10.1200/jco.2000.18.1.102

: This study expands the existing limited data as to whether patients developing clinically significant paclitaxel-induced hypersensitivity reactions can continue to be treated with this important antineoplastic agent and how such retreatment might be undertaken. More than 450 patients received paclitaxel, either as a single agent or in a combination regimen, for a female pelvic malignancy in the Gynecologic Oncology Program of the Cleveland Clinic Cancer Center from January 1995 through December 1998. Of the more than 450 patients, 44 (approximately 9%) developed at least one episode of a clinically relevant hypersensitivity reaction to the cytotoxic drug. All 43 individuals (plus an additional four patients referred to our center after having previously experienced a severe paclitaxel-associated hypersensitivity reaction at another institution) who were retreated with paclitaxel were ultimately able to receive the agent. Five patients required treatment with a standardized desensitization regimen, developed by our group, to successfully receive paclitaxel. On the basis of this large single-institution study of paclitaxel-associated hypersensitivity reactions, we conclude that with appropriate precautions essentially all individuals experiencing these reactions can be safely treated with this agent.